Continuity of Care
When you switch health plans, you may be eligible to continue your care with your current doctors or medical groups. This is called Continuity of Care. You have 60 days after you are enrolled in this plan to request Continuity of Care.
Here is a list of conditions eligible for Continuity of Care:
- an acute condition;
- a serious chronic condition – up to twelve months;
- a pregnancy (including the duration of the pregnancy and immediate postpartum care);
- maternal mental health – up to 12 months from the diagnosis or from the end of the pregnancy;
- a newborn up to 36 months of age - up to 12 months;
- a terminal illness; or
- a surgery or other procedure that has been authorized and scheduled by your prior health plan as part of a documented course of treatment within 180 days of new plan effective date.
Medical
If you or a family member gets medical treatment from an out-of-network provider for one of the medical conditions above, complete this form (PDF) or call Member Services for Health Net CanopyCare HMO at 833-448-2042 (TTY: 711) as soon as possible. A representative will help you determine if you're eligible for continuity of care assistance.
Pharmacy
In order to avoid any issues with your prescription in the first 90 days, please complete one of the prescription transition of care forms:
Behavioral Health
If you (or a covered family member) are getting mental health services or substance use disorder treatment, call the Mental Health Benefits number listed on the back of your Health Net ID card as soon as possible. If your current provider is not in our provider network, you may be eligible for Continuity of Care. You will be connected with a care manager who will review your status and will either arrange for a medically appropriate transfer of your care to a Health Net participating provider, or will facilitate a Continuity of Care request.